4. EFFECTIVE Trauma Therapy

This is part 4 of the concise “miniseries” on CPTSD community learnings so far.

For the podcasted version of this post, hit up the Podcast tab or search for “CPTSD” wherever you listen.

For more information on these topics – including a few hundred already-recorded episodes, hit up patreon.com and search “traumatized motherfuckers.” Jump into the community while you’re there and say Hey. No one will tell you to look on the brightside.

Cheers

Jess


Unsponsored personal promo: To get affordable therapy, hit up OpenPathCollective.org


Fantastic, what’s a Fucker to talk about now that we know a thing or two about the mechanisms and likely outcomes of PTSD and CPTSD?

How about… changing those outcomes, by finally finding someone who can fucking help you?

Because, I know, therapy probably hasn’t been a walk in the park so far. If you’re here, you’re probably looking for more information, more help, or more reassurance that you’re not the only one looking for a way out. A supplement to therapy, if you’re even open to counselling at all right now.

And that’s what I recommend you use this show and community as, if you want to be involved – a supplement to therapy. I can talk about the background of trauma, the experiences of trying to live despite a set of messy neural connections, and the ways I’ve figured out how to move on… we can all support each other through rough times… but that’s not a substitute to having a professional to keep you grounded, processing the right materials, and creating personalized progress goals in line with your individual struggles.

As someone who did NOT want to go to therapy, after two very bad experiences with people who didn’t know what the hell they were doing, I can tell you, my trauma brain completely changed the day that I found someone who could actually talk to me about what was going on in the right way. Not someone who just wanted to talk-therapize me.

The difference being?

What you want, first and foremost, is a trauma TRAINED and EXPERIENCED practitioner. You do not want to get a general-therapist or someone who has a bit of knowledge when it comes to depression and anxiety, the most sparkly symptoms that you might THINK you want to tackle… but, honestly, you won’t fix them if the wiring is still all janked up underneath.

You need the specialization of trauma therapy to be firmly under their belt. THEY need to guide the sessions, with intention. This shouldn’t be a situation where you walk into the office every day and they ask casually “so what do you wanna talk about today?” At least, not in the beginning, when there’s heavy lifting to do and unknown triggers to watch out for.

What’s the difference between a trauma therapist and any old counselor? They need to know how to interact with your brain programs without setting them off. They need to give you the validation that what you’ve been through can lead to the issues of X Y and Z. They need to be able to re-ground you after visiting the past and trying to do some processing work together.

They need to understand your rapidly, biologically programmed, shifting emotions, energies, perceptions, behaviors, and even opinions about therapy, itself. They need to know about dissociation (and, likely, dissociative identities, but we’ll get to both later). They need to be sensitive to the influence of shame, of self-blame, of criticism – even to the influence of ambiguity. And they need to know how to help you move past it, knowing that at the core of the issue is a loss of “self” and a sense of perpetual helplessness that cascades into a “why even bother” outlook on existing every few months, weeks, or hours.

But, in the beginning, most importantly, is their ability to help you resolve erroneous memories from the past without letting you get engulfed in them.

Which is where many of our therapy efforts fail, immediately.

For us, therapy isn’t going to be about just letting our brains wander or talking about our childhood for 30 minutes at a time. It’s going to need to be directed. And it’s going to need to be conducted, intentionally, in line with whatever else is going on in our lives.

For instance, if you’re in an extremely stressful time at your job, it’s not a great moment for your therapist to throw you into the deep end of your early abuse. If your energy starts changing, your cognitive patterns are negatively shifting, and you’re on the verge of kickstarting an anxiety or obsession based mental program, they need to feel that vibe change and pull you back out of it.

This is the real work that trauma therapists have to take on. Not to mention, upholding those safe and firm boundaries so they don’t get any trauma transference or emotional enmeshment going on.

Meaning, I know transparency can be reassuring, but you also don’t want to get a therapist who is a bit TOO friendly with you. You honestly probably shouldn’t know much about their background or personal history. You shouldn’t be texting or calling them with crises too often. There shouldn’t be any threat of multiple forms of relationships going on – your therapist is your therapist and that is all.

For those of us with CPTSD, this can be a painful fact to accept, and we can let these lines get blurry. We often haven’t felt seen or accepted before in the way that a trauma therapist can impart. We might transmit feelings on to them, like they’re saviors, best friends, or substitute mothers. And this all needs to be at the forefront of the therapist’s mind. Otherwise, it can be destructive for everyone. EDIT: It WILL be destructive for everyone.

SO, don’t take it hard if they set firm boundaries with you. If you only see or hear from them during set office hours. If you ask questions that they kindly refuse to answer. If you can’t text them during every emergency. If you start to feel like you might care about them more than they care about you. If you realize one day… that you’re paying them for a professional service, and this is a strictly professional relationship.

It’s not personal, these boundaries are the way to heal your brain.

These are all normal things that can happen during therapy which throw us for a loop and make us question the whole nature of the relationship and if we trust them. But, unfortunately, they’re just patterns that we’re not accustomed to, after a lifetime of people being pretty inappropriate and calling it “normal.”

So, right there, are two major points that stop us from getting the help we need.

  1. You have to get a trauma specialist. No, no other kind of therapist will do.
  2. You have to understand that they are treating your brain, which might mean that you have different instincts, expectations, and desires than they know through training and experience, are the best ways to help you.

Thirdly… you’re going to want to find someone with the same beliefs as you, on a core level.

As in, don’t go seeing a religious counselor if you’re an atheist. Don’t see a conservative therapist if you’re LGBTQ. Don’t talk to a Western Medicine educated psychiatrist if you’re looking for a holistic approach.

And you can find these things, fairly easily, through using the Psychology Today provider finder resource, for starters. It’ll at least help you weed out the people that you don’t jive with, right away. During your first sessions, don’t be afraid to ask your therapist about their opinions on any of these important areas of life. And don’t forget that you’re letting these mental health professionals audition, in a way, to be your primary therapist. A pretty big role.

You aren’t looking for just “whoever can take you.” You’re looking for the right fit. If it’s not feeling right, you don’t have to keep at it. You can find another provider, today more easily than ever, thanks to all the telehealth options. You can talk to anyone, anywhere, even if your immediate environment isn’t providing great opportunities. As someone who grew up in a backwards-ass cornfield town with racist undertones, holler.

Don’t give up. Don’t work with someone who’s going to make the issue worse by accidentally shaming you for lifestyle differences. Don’t work with someone who doesn’t seem to respect your goals or necessity for pacing. But also don’t work with someone who’s not going to make you feel better by being too laxadonical or failing to set new goals for you. And if you find yourself failing to make new progress with your old practitioner, you might want to consider a change-up to kickstart a new recovery process.

What else can we say here?

Psychiatrists. Let’s talk about getting some medical help when you’re starting therapy.

Lots of us need a little chemical boost to even things out and stabilize what’s been headed rapidly towards disaster. And that’s completely fine. It’s a good idea to get to a safe, secure place if you’re on the edge of giving up entirely. When things are at “crisis” level, I think that medication can be the best way to take it all down a notch.

BUT. (And, remember, what the fuck do I know? Nothing. I’ll say it time and time again.) Be wary of providers who want to throw you on too much medication right off the bat. Or professionals who aren’t prescribing meds that feel in-line with what you’re trying to describe. Or family members who are pushing you to just “get it over with and do something already,” meaning, take a pill and your broken brain will stop negatively affecting them.

Make sure you trust your psychiatrist just like you trust your therapist. Your impressions matter. You can talk to more than one provider, if in doubt. I realize it’s not cheap, but it’s a lot cheaper than losing years of your life to being in a pharmaceutical coma that wasn’t treating the underlying issue anyways. Got friends who can attest.

So, let me tell you my opinion. You can absolutely ignore it. But I believe that psychotropic meds play a big role in getting folks out of dangerous mental situations – when suicidal ideations are running rampant or functionality has slipped down near 0. However, I don’t believe that they should be a lifelong condition.

As a biology nerd, I think the body functions best when you aren’t pumping it full of exogenous chemicals. I also don’t believe that biochemical imbalances are the basis of mental illness, as some companies changed the narrative to suggest. I think they’re often a symptom.

So. I think (but what do I know) that there’s amazing potential in getting on a mood stabilizer, antidepressant, or antianxiety med… short-term. This might allow you to deactivate some default brain programs, which allows you to work on rebuilding the broken ones or creating better ones. But the actual REHABILITATION part of the process is making those neurological architecture changes, little by little, over time, to resolve whatever patterning is causing you to spiral out into depression, anxiety, obsession, and every other kind of fit. Not the “insert neurotransmitter” part.

DO those brain programs CAUSE biochemical imbalances? Yes, I believe they do. But does treating the downstream effect of dysregulated neurotransmitters travel backwards to correct the mental shittery that’s causing all the brain and emotional upset long term? No, I don’t think it works that way.

Again, not a professional. Listening to me could be dangerous. I could be wrong. I just know what I’ve seen and learned so far.

Try meds. But don’t lifelong-rely on meds. That’s my standpoint.

Overall, just make sure that your psychologist and psychiatrist are working together. Don’t see a regular primary care physician for the medicine that’s going to make or break your brain functionality.

And try not to get TOO married to the idea that these artificial chemicals are saving your soul. Honestly, it cuts out ANOTHER pretty important part of the puzzle, which is believing that you have the power to make changes. Counting on medication means you don’t think you’re capable, yourself. It makes you dependent on an outside factor – a prescription. And that’s a bit of a learned helplessness continuation at the core, now isn’t it?

As far as knowing what the best kind of help for you really is… well, realize that there are trauma specialities within the trauma specialization, as well.

Do you want someone who does EMDR? Or, the bilateral eye movement therapy that helps you process old traumas more effectively? Maybe.

Do you want CBT? Or, cognitive-behavioral training that teaches you how your brain and feelings are interacting to create your reactions? Maybe.

How about DBT? Or, dialectical behavioral therapy that helps you build mindfulness, emotional control, personal effectiveness, and distress tolerance? Maybe.

Do you want an IFS practitioner. Or, internal family systems therapy, which examines the multiple neural structures in your head that present as distinct “personalities,” and are accessed through dissociative events? Maybe.

Do you want an ACT therapist? Or, acceptance commitment training, which teaches you to stop ruminating and start absorbing newly presented information so you can start making definitive decisions and moving forward more quickly? I mean, I recommend this a lot… but I’m biased, so… maybe.

There are a lot of approaches. And you might find that the answer is “a little of all of the above.” There’s no way to know until you find out through experience and see what works. Different strokes for different folks. You’re going to have to decide, first, what makes the most sense and makes the most difference for YOU.

This is YOUR therapy, your recovery, your life.

But if you want to ask a few hundred Fuckers who’ve already been through it about what THEY’VE figured out… you know where to find them. Head to the TMFR private community, available through Patreon and the Patreon-gated Discord, and get chatting with more than this one individual perspective. Find out what fits for you. And get the social support on the other side of therapy, to enable your professional progress to continue.

If you’re into the idea, hit up t-mfrs.com or patreon.com/traumatizedmotherfuckers to get more information, more connection, and more support than you’ve possibly ever received before. Even if you ARE an experienced therapy client.

So I’ll see you there, in the TMFRs community where you can get tons of information on your brain and your experience so far, via 1-200 some podcast episodes already published and waiting for your consumption. They span everything from the neuroscience to the not-so-compliant, brain-based experiences of living with unmanaged CPTSD in the early days, today, and pretty literally everything in between.

Until next time, when I throw some more mental nutrition at you.

See you there. Or, at least, some version of you. Even if it’s only your brain OR your body calling the shots.

Because next time, we’re talking about dissociation.

See you then, or in the TMFRs private community… where we’re talking about “trauma advanced” topics these days, like “Closure of background brain processes.”

Plus catch up on those experiential and early learning discussions from every day leading up to the present. Shitty figures and videos included.

Cheers y’all.

YermotherfuckerJess

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